Intervention of Mindfulness and Growth Mindset: A Mixed Methods Study

Undergraduate Applie

Associations between the use of herbal medicines and adverse pregnancy outcomes in rural Malawi : a secondary analysis of randomised controlled trial data

BACKGROUND: The use of herbal medicines during pregnancy is very high globally and previous studies have pointed out possible associations with adverse pregnancy outcomes. Nevertheless, the safety of herbal medicines in pregnancy is under-explored in low-income countries experiencing high maternal and neonatal complications. We investigated the associations between self-reported use of Mwanamphepo (a group of herbal medicines commonly used to induce or hasten labour) and adverse maternal and neonatal outcomes in rural Malawi. METHODS: We conducted a cross-sectional analysis of secondary household data relating to 8219 births that occurred between 2005 and 2010 in Mchinji district, Malawi. The data were collected as part of a cluster-randomised controlled trial (RCT) that evaluated community interventions designed to reduce maternal and neonatal mortality. Data were gathered on maternity history, demographic characteristics, pregnancy outcomes and exposure to Mwanamphepo. Associations between self-reported use of Mwanamphepo and maternal morbidity as well as neonatal death or morbidity were examined using mixed-effects models, adjusted for relevant covariates. All analyses were also adjusted for the clustered nature of the survey. RESULTS: Of the 8219 births, Mwanamphepo was used in 2113 pregnancies, representing an estimated prevalence of 25.7%. The self-reported use of Mwanamphepo was significantly associated with increased occurrence of maternal morbidity and neonatal death or morbidity. Specifically, the odds of maternal morbidity were 28% higher among self-reported users than non-users of Mwanamphepo (AOR = 1.28; 95% CI = 1.09-1.50) and the probabilities of neonatal death or morbidity were 22% higher (AOR =1.22; 95% CI = 1.06-1.40) among neonates whose mother reportedly used Mwanamphepo than those who did not. CONCLUSION: The use of Mwanamphepo was associated with adverse pregnancy outcomes in rural Malawi. Thus, herbal medicines may not be safe in pregnancy. Where possible, pregnant women should be discouraged from using herbal medicines of unconfirmed safety and those who report to have used should be closely monitored by health professionals. The study was limited by the self-report of exposure and unavailability of data relating to some possible confounders

Regularized Maximum Likelihood Image Synthesis and Validation for ALMA Continuum Observations of Protoplanetary Disks

Regularized Maximum Likelihood (RML) techniques are a class of image synthesis methods that achieve better angular resolution and image fidelity than traditional methods like CLEAN for sub-mm interferometric observations. To identify best practices for RML imaging, we used the GPU-accelerated open source Python package MPoL, a machine learning-based RML approach, to explore the influence of common RML regularizers (maximum entropy, sparsity, total variation, and total squared variation) on images reconstructed from real and synthetic ALMA continuum observations of protoplanetary disks. We tested two different cross-validation (CV) procedures to characterize their performance and determine optimal prior strengths, and found that CV over a coarse grid of regularization strengths easily identifies a range of models with comparably strong predictive power. To evaluate the performance of RML techniques against a ground truth image, we used MPoL on a synthetic protoplanetary disk dataset and found that RML methods successfully resolve structures at fine spatial scales present in the original simulation. We used ALMA DSHARP observations of the protoplanetary disk around HD 143006 to compare the performance of MPoL and CLEAN, finding that RML imaging improved the spatial resolution of the image by up to a factor of 3 without sacrificing sensitivity. We provide general recommendations for building an RML workflow for image synthesis of ALMA protoplanetary disk observations, including effective use of CV. Using these techniques to improve the imaging resolution of protoplanetary disk observations will enable new science, including the detection of protoplanets embedded in disks.Comment: 27 pages, 12 figures, accepted for publication in PAS

Protocol for integrating mental health services into primary healthcare facilities : a qualitative study of the perspectives of patients, family members and healthcare providers in rural Bangladesh

INTRODUCTION: In Bangladesh, Non-communicable diseases (NCDs) account for 67% of all deaths. Mental health services are not available in routine healthcare at the primary facilities in Bangladesh. The protocol is for a qualitative study that seeks to understand the perceptions, beliefs and norms regarding common mental disorders (CMDs) among patients with NCD with and without CMDs to identify barriers to accessing mental health services in rural communities in Bangladesh. We also aim to explore the feasibility of integrating mental healthcare into routine NCD services at primary health facilities in rural Bangladesh. METHODS AND ANALYSIS: This study will be conducted at the outpatient departments in two subdistrict hospitals and one district hospital in Munshiganj district in Bangladesh. We will purposefully select patients with hypertension and diabetes from the patient inventory generated from a recently completed randomised control trial titled ‘Control of Blood Pressure and Risk Attenuation Bangladesh, Pakistan, Sri Lanka’ in two subdistricts in Munshiganj district in Bangladesh. The selected participants will be screened for CMD using the Depression, Anxiety and Stress Scale - 21 Items (DASS-21) over the telephone. Sixty in-depth interviews with patients and family members, 8–10 key informant interviews with healthcare providers and 2 focus group discussions with community health workers will be held following consent. The study is conceptualised under Levesque et al’s framework. Thematic analysis will be applied following the study objectives and key issues, and commonly emerging topics generated by the data. The findings will be presented anonymously to corroborate the interpretation. ETHICS AND DISSEMINATION: Approval has been obtained from the Institutional Review Board at icddr, b (PR-19108) and the University of York (HSRGC/2020/382/F). Written informed consent or audio recording consent form in Bangla will be obtained. For dissemination, we will invite representatives of the collaborating institutions to share the findings in national or international conferences and peer-reviewed journals